Data methods used by VA portray actual Veterans experience

VA is committed to providing high quality, proactive, personalized, patient-driven care to Veterans and strives to improve our services. We are determined to rebuild the trust of Veterans and stakeholders and improve service delivery by focusing on Veteran outcomes.

Some Veterans are still waiting longer than they desire for their appointments, and we are working hard to try to get them the care they have earned where and when they need it.

We realize appointment wait-time data, and how it gets calculated in a system that schedules over 80 million encounters a year, can be complicated and hard to understand—so we want to take this opportunity to explain our methods. We are working in good faith to be as transparent and open as possible with our data, and the way it’s calculated.

VA began publicly posting patient access data online in June 2014. You can find that data here. Back in October, VA made clear that, as directed by Congress, it was establishing new wait-time standards that more accurately reflect whether or not a veteran has been waiting too long for an appointment. VA has done just that, and has been fully transparent about it all along. We began reporting average appointment wait times in two categories: completed and pending. Both of these measures are determined based on the Veteran’s preferred date. The preferred date method is based on a clinician’s specified date for the patient to be seen, or in the absence of a clinical recommendation, the date a patient wants to be seen.

We report this completed appointment average wait time data monthly. VA also regularly advises and updates Veterans service organizations and congressional stakeholders on our patient access data and wait time methods.

VA considers completed appointment data to be the best indicator of the Veteran’s actual wait time experience. It is the average wait time between the preferred date (the date the Veteran prefers to be seen or the date determined by the Veterans physician as clinically appropriate) and the actual date VA completed the appointment. The public data for each reporting period is based on when appointments actually occurred, and takes into account appointments that were moved up, cancelled, rebooked, missed and/or added during the month. VA considers it to represent most accurately what the Veteran experienced.

VA also reports access and wait times in terms of pending data. This is the average wait time between the preferred date and the date the Veteran’s appointment is scheduled to occur. Because this data is aggregated every two weeks, it is important to understand that it does not include same day appointments and those where the preferred date and appointment occurred within two weeks. As a result, pending data wait times can appear to be longer. But, they are not what VA considers to be the true measure of how long Veterans are actually waiting. That information is represented by the completed appointments data.

A recent media story alleged that VA may have provided misinformation about patient wait times in congressional testimony on February 10, 2015, and that wait times in facilities like the Greater Los Angeles VA Health Care System may be much longer than VA has publicly reported.

This assertion is incorrect.

VA officials responded in congressional testimony with accurate data for completed appointment wait times, based on VA’s known and publicly released methods to compute access data and wait times.

The recent media story regarding wait times in the Greater Los Angeles VA Health Care System was based on information that detailed pending new patient wait times based only on when VA schedulers created the appointment in the scheduling system. It does not reflect when the appointment actually took place and was completed. It’s inaccurate to draw the conclusion from that data that these are actual Veteran wait times for appointments.

The measure that matters most is patient satisfaction. VA is committed to providing care when and where the Veteran wants it. Our Veteran Experience Committee is working to ensure we have a clear understanding of how Veterans perceive VHA health care. We want to incorporate that knowledge into our strategic decision-making, and use it to improve the Veteran experience and access to care.

We welcome and encourage feedback and suggestions on how we can improve Veterans access to care as we continue to seek to regain the trust of those who count on VA.

Editor’s note: This blog was updated on April 8, 2015.

Dr. Carolyn M. Clancy is the Interim Under Secretary for Health for VA’s Veterans Health Administration.

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Comments

VA in Atlanta quickly learned how to finagle new rules and measurements to improve their computerized scores and to reduce the ease-of-use and frequency of my exams. Primary Care can no longer put me in the computer for 6 month followup, so I have to go back in person a month before next exam is due to ask for an appointment. I was previously on 6 month checkups in VA computer due to 2011 quadruple heart artery replacement, diabetes, hypertension, and high blood pressure.

VA has modernized by “pencil whipping” reports with computers…adding to inefficiency and adds demand for more VA staffing…the unions love it!

Also, it took 4 months longer to get a teeth cleaning appointment by VA Dental no longer using the computer…now 16-17 months between cleanings. Current VA system is to leave a note in Shiela Patterson’s paper mail tray, and this still requires me to call weekly for an appointment. I drive to VA after her voice mail box is full to ask for appointment.

Atlanta VA is moving a lot of services out of the Regional Hospital to satellite clinics. Watch the Region Hospital computerized scores sky-rocket upwards as many appointments are no longer tracked. Smoke and mirrors, Private…smoke and mirrors!

I waited for over 5 hours at the los angeles location, barely able to stand, which conveniently was my only option as all of the seats were taken. I gave up after a psychologically afflicted homeless veteran took interest in me and the remainder of my visit was basically me avoiding him until I was so exhausted that I called for a ride home, without ever being seen.

“We realize appointment wait-time data, and how it gets calculated in a system that schedules over 80 million encounters a year, can be complicated and hard to understand—so we want to take this opportunity to explain our methods.” Doesn’t the software have the desired date & the actual date stored in a database? If so, this computation is fairly easy to figure out.

As to the politics, especially what they still call conservative ideology, seeking to privatize the people served responsibility for corporate profit, the ‘support the troops’ is like the arguements of ‘right to life’, only when serving, as the so many issues are ignored or out right denied exist {PTS, Agent Orange,Gulf War Syndrome, Burn Pit contamination, Homelessness to name but only a few}, finally being addressed and still under funded and thus not built as promised by the Shinseki administration that continues under McDonald and with needed help from the Obama Executive branch and it’s Cabinet, and one serving better be walking in lockstep with the idelogies, during operation theaters and out of mind by those served after:

ProPublica and The Seattle Times Nov. 9, 2012 – * Lost to History: Missing War Records Complicate Benefit Claims by Iraq, Afghanistan Veterans *
While under both bushes:
>”DeLara’s case is part of a much larger problem that has plagued the U.S. military since the 1990 Gulf War: a failure to create and maintain the types of field records that have documented American conflicts since the Revolutionary War.””During and immediately after the first Gulf War, more than 200,000 of 700,000 U.S. troops sent to Iraq and Kuwait in January 1991 were exposed to nerve gas and other chemical agents. Though aware of this, the Department of Defense and CIA launched a campaign of lies and concocted a cover-up that continues today.””When Brown and others tried to obtain their medical records to prove their illnesses were service-related, they learned that the records had disappeared.”<

Sen. Bernie Sanders told Conservatives: “If you can’t afford to take care of your veterans, than don’t go war. These people are bearing the brunt of what war is about, We have a moral obligation to support them.” February, 26th, 2014
Neither of these recent wars have yet been paid for, nor the continued blowback from the spread and growth from the policies implemented!

Neither the long term results from, including the long ignored or outright denied existence of, till this Administrations Cabinet and Gen Shinseki, only Government branch consistent for the past six years, Veterans issues from!

As well as under deficits most of the, grossly under funded for decades and the wars from now, VA budget is still borrowed, with interest, thus added problem creating costs, with representative who control the purse strings blaming the mostly dedicated VA personal within, that shouldn't exist!

there’s only one way to look at America’s veterans administration tell me what is it mean to have crimes against humanity
people murdered disillusioned and made to believe there are disgrace to their own nation nobody cares

You can expect longer wait times here in Las Vegas. Our new assistant Chief of Staff has determined that we are overmanned by 40 heath care providers. Sounds as if the assistant Chief of Staff does not understand how to effectively use his resources. Just last year when Sec. McDonald visited the VA Medical Center stated that we needed to hire more health care providers, and indeed Ms Duff the Medical Center director stated in media interviews that the VA was looking to hire more providers. I guess this is another example of the VA LYING TO THE PUBLIC AND TO THE VETERANS!

” It is the average wait time between the preferred date (the date the Veteran prefers to be seen or the date determined by the Veterans physician as clinically appropriate) and the actual date VA completed the appointment.”
That is not solution, but rather part of the problem. Any equation that utilizes incorrect data will yield misleading answers.
Using my own case as an example so that I can speak from first hand knowledge:
“…the date the Veteran prefers…”, first question that must be asked is whether or not the local offices are placing that data into the system correctly. The simplest way to askew the data would be to corrupt this data point. For myself I have been fighting for over five years with the VA in Colorado and yet to attain my initial appointment. Thus my preferred date was five years ago, a data point not reflected in any of the equations.
“…date determined by the Veterans physician as clinically appropriate…”. This is point that is impossible for any medical system. Appointment setters are not medically trained and hampered by the restrictions of available space. If the doctor wishes to see you monthly, yet the case load is book for two months, two months it is. The doctors input becomes meaningless. It is quit a moot point for myself, after all I have yet to see a VA doctor for them to make any determination as to necessity.
So for veterans like myself who have been fighting for years for an appointment, the number presented are terribly wrong. Or, worse yet veterans are once again completely ignored by the VA and not part of the wait time equation at all. My personal experience is closer to the latter. I spent most of the day yesterday, as I have the first day of every month for over five years, being transferred around, placed on hold and having calls dropped. Since the VA in Colorado is unwilling to make an appointment, I doubt seriously that I even fit into the equation…or for the matter even matter as a human being .

I read some of the revistion the president sign for us Veterans for timely medical appointment schedules. Which I yet to see any change yet my primary physician put me in to see a acupuncture Dr. They called me for a appointment last month and the soonest they could give me was in June 3 months. I guess that’s not bad but until then I have to put up with the pain. That’s number one the next one is the statement the president said was that the interviewers for our veterans should make it easier for us who do have claims for P.T.S.D for the Vietnam Veterans even though it’s been 40 yrs. One thing is that P.T.S.D has only been recognized in the pass 10 yrs. Recently I had a interview with a physiologist for my P.T.S.D and when the VA sent me a letter for the appointment it was stated that it could take 4 to 8 hrs. Well mine took 1hr and 20 minutes about 40 minutes longer then my hearing test. Half that time was her typing. She asked me a few questions not letting me give any prolong answers or let me relate what I went through there and what I have been going through since then or how the things that I went through makes me feel today. See now a days and I am not taking any thing from our vets that have fought in the mideast. They have more written records of thier missions nowadays that are kept as like us Vietnam vets. we are the only ones that can tell our story of what we done and went through while we were there. Any as usual and I hate to say this I am pestimistic of my out come of that interview and I am ready to appeal and to tell my story and release some of these demons that have been hunting me these pass 45 yrs. So I am allotted my true benifits that was cause for serving our country. Even though I was drafted I didn’t slack in performing my duties in fact I was at times did the job that one of the career men should have been assigned. Well this is all for now hopefully we will start being taken care of as we should be.

Corrections..
We are determined to rebuild the trust of Veterans and stakeholders – Respect Must be EARNED and with the VA’s Baggage of over 70 years Mistreating Veterans you’ve got a lot of earning to just break even.

VA has done just that, and has been fully transparent about it all along – AFTER VA got burned by Cheating VAMC’s

VA officials responded in congressional testimony with accurate data for completed appointment wait times, based on VA’s known and publicly released methods to compute access data and wait times – This Statement ASSUMES that all of those who prior to 2014 Scandal have either been fired or reconditioned to no longer manipulate the system. Since it is scarcely believable that any true in depth investigation could have possibly been done of the 152 VAMCs much less of the thousands of clinics funneling patients to the VAMCs. The Fact is a News Service interviewing Veterans probably has more facts that any report in your system. Finish Cleaning your House before you say there is no dust.

Ms Interim Under Secretary for Health for VA’s Veterans Health Administration. You wish Comment and Suggestions? Here you go… Your “System” Has gone from one scandal to another since 1946 before you start cheering and raising a “Mission Accomplished” Banner you’ve got to run a top to bottom inspection of the entire system. Only having reviewed everything that you have can you even hope to fix everything that is broken. There is no way that any kind of system analysis could have been done in the less than a year that has passed since the scandal broke. The average US Veteran is not a fool and knows how large scale systems operate, we served in one of the biggest! So stop insulting us with magic wand results.. aside from not being fools we talk to each other and hear from our brothers in arms that the delays are still there, what’s more we are already hearing new lies from VA employees designed to try and circumvent the Choice program. Lies like scheduled appointments don’t have to meet the 30 day standard… HUH?? If I see my clinic Dr. or call him needing to see an Orthopedist and am given the number to that department and then call them and receive an appointment date that’s 2 months in the future… well even a Vet can count…

My recommendation? Inform Congress that your system needs a complete overhaul and expand the Choice system so that it can take the pressure off your system while you revamp and institute changes. Then take your systems and before you return to “systems” that can make an injured or sick Veteran have to travel hundreds of miles to get treated. Think for a moment, if you had ohh let’s say gotten caught in the explosion of an IED and once stabilized though still requiring more surgery and intense physical therapy only available at a state of the art hospital would you pick a hospital hundreds of miles from your home? Of course you wouldn’t and neither should injured Vets have to travel so far for care when there may be a score or more of perfectly good hospitals between their home and a VAMC. Ms Undersecretary the VA isn’t just broken it’s worse since the first breaks in it back in 1947 National attention to it has waxed and waned allowing the VA “breaks” to knit without being properly set… Even a 1st year Med student can tell you that an unreduced or ill set break that heals will be weak and prone to fracturing again with any significant pressure applied. Just so the VA with it’s 152 Hospitals and it’s attitude of if you want treatment come where we are to get it or just die attitude needs to change. Congress even gave you a loophole with the distance part of the Choice plan since we know that the care available at the clinics is little better and sometimes less than can be found at any GPs office. Sure Joe Veteran might only be 10 miles from the closest clinic but it does him little good if he lives 300 miles from the closest VAMC. I’m not saying there should be a VAMC around every corner but for Vets who weren’t lucky enough to call home a five minute walk from a VAMC should have an alternative. If you truly are looking out for the Veterans best interest you’ll find that alternative even if the VA may have to share some of it’s funding with an expanded choice system that would better serve all Veterans. I hope you do, I sincerely hope that this time the repair of the VA system will be accomplished in fact rather than in a report.

I applied for VA disability at Temple, Tx. VA center in July 2010. After 2 years they denied it. I reapplied again and included letters from my doctors in Aug. 2013. I still have not heard anything back. I just don’t understand why it takes so long for this to take place.

I applied for VA disability for PTSD and hearing loss in July 2010 at the Temple, Tx. VA center. After waiting 2 years they denied me. I re submitted again with letters from the VA doctors in Aug. 2013 in which they stated they got the claim again. Well it is April of 2015 and I still have not heard anything. Whey does it take so long?

Began Dental treatment February 3, 2014. Have complained to Department of Veteran Affairs many times about the long wait to gain the teeth needed to properly masticate food. The reason given by the Dentist was, ” Because Mr. Omar transferred from another V. A.” The Dentist is question claimed that implant parts were needed and difficult to get, as the reason for such a long wait. And now that the process of making partials for me and fitting them has materialized, he claims that the lab failed to take into consideration of the implants on the left side of my face, that the implants are causing difficulty in delivery of said implants to the partial. It appears to me that the dentist in question never, I repeat never intended on utilizing the implants, even after statintg that the reason for the delay was to get parts for the implants. Unlike the implant in the front of my mouth as well as the one on the right side of my mouth, healing abutments were attached to the implants which allowed the lab to pin-point the location of the implants, there by allowing for less possibility of a mis-fit. I have an appointment for may 1, 2015. That appointment was made mid March. This is very frustrating because the dentist accuse me of being impatient and hostile and in turn tells Department of Verterans Affairs a completely different account for why it has taken so long. I have in my possession all of the records of all notes pertaining to my situation and they reflect an entirely different view of how and why the teeth that were made for me don’t fit and are causing me pain while eating!

Data on making appointments is misleading. I received two appointments that were useless and delayed treatment. I contacted the Choice program when I had a VA appointment with a neurologist in 60 days at a VA center 50 miles from my home. I was told the Choice program could get me a program with a private physician in 30 days. I canceled the appointment with the VA and 10 days later got the appointment information in the mail. It was for a neurologist 70 miles away. This was unacceptable. I called the Choice program and they said they could get me an appointment closer. They called me in a few days saying they had set up an appointment 20 miles away for the following week and gave me the name and number of the physician. I called to confirm the appointment and learned the physician was not a neurologist. He was a psychiatrist. At that point I decided the Choice program was useless and called the VA for a new appointment. Because of the incompetence of Choice works I had to wait an additional 45 days.
I have posted my experiences on Facebook pages of the American Legion and Military.com. Others have said they have had similar experiences. I have informed my Congressman, Ed Whitfield and a local TV reported of the Facebook posts that have nothing but negative remarks to make about the choice program.
When Congressman Whitfield inquired at the Marion VA the VA representative told Whitfield I was not eligible for assistance from the Choice program because I had been “given an appointment in due time” Whitfield informed me of that in a letter and I replied saying that information was totally false and the VA should be asked to document the date the referral was made and the date of the first appointment.
The VA can report any way they please. Angry and frustrated veterans can document proof of poor service and unwillingness or incapability of Choice workers to perform satisfactorily
Richard Gaskill
Owensboro, KY

I live in South Carolina. I have not seen or experienced changes in wait times. I experienced over 60 days to see Mental Health. Also, I have been waiting 405 days waiting on my appeal and I cannot work because of the disability.